This demonstration is proposed to support the need of the AHCPR to disseminate effectively the findings of the research its sponsors. The proposal has three objectives: 1) to demonstrate the study group/data feedback approach produces behavior change in physicians, 2) to determine via survey research the effect of the data feedback process on physician knowledge and attitudes, and 3) demonstrate that the feedback approach can, be used to disseminate PORT findings, practice guidelines, and other outcome research findings to practicing physicians. The demonstration project will be centered on five specialty study groups spanning northern New England. Study groups will serve as specialty committees to acquire in-depth knowledge about small area variation data, PORT findings and practice guidelines. They will develop plans for addressing outliers, disseminating findings and guidelines, and monitoring behavior change. Following feedback of data and findings, behavior change will be monitored as reflected in the hospital discharge and Medicare claims data. It is proposed that the post-feedback behavior change seen in Maine can be replicated in New Hampshire and Vermont. Study group physicians will be surveyed three times during their first year of study group participation and once annually thereafter. The principal focus of the surveys will be to monitor the views and feelings of physicians in study groups, including their views of the program, their perceptions of the area variation phenomenon, the significance of practice style, and the quality of information available to physicians about outcomes. In addition, on a specialty basis, we will design questions to measure perceptions about treatment strategies, PORT findings and practice guidelines.